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The idea of partnerships and collaboration across organisational boundaries is at the heart of NHS reforms in England. Although we have helped to develop the evidence base for how networks of people can improve quality of care, less is known about what makes for successful partnerships between providers at an organisational level.

For this reason, we commissioned the Health Services Management Centre at the University of Birmingham to look at a range of current organisational partnerships. This report focuses on five different partnering arrangements, as well as interviews with national leaders, and draws learning to help inform and guide policymakers and providers.

Key points

  • The Dalton review and the Five year forward view both emphasise that there is no ‘one size fits all’ model for provider organisations or for service delivery. The onus is therefore placed on providers to select and adapt the approach that best suits their own aims and objectives.
  • The report provides a snapshot of some of the key ingredients needed for successful partnerships. It highlights that partnering across clinical, institutional and geographical boundaries has the potential to maintain and improve quality at a time of substantial financial pressures and demographic change.
  • Given the commitment of time and resources involved – in an environment where financial and human resources are scarce – informed decision making on entering into a partnership of any kind is vital.
  • Different types of partnerships can make a positive contribution to improved quality, given the correct opportunities, investment and environment.
  • Partnerships vary in terms of nature, scale and form. They may:
    • range in terms of ambitions, objectives and mechanisms to drive improvement
    • range enormously in scope, from small-scale collaborations between individual clinicians to the structural integration of entire organisations
    • be initiated voluntarily to pursue opportunities for improvement, or be mandated by regulators as part of a response to organisational or quality failures.
  • Partnering does have potential benefits, but these are not easy or quick to achieve. To have a meaningful impact on the quality of care, the right form of partnering needs to be used in the right context and it needs to be accompanied by the right set of enabling factors – as described by the report.
  • Read the more detailed research report, Partnering for improvement: inter-organisational developments in the NHS.

Further reading

Is together always better?

How good are NHS organisations and the wider system at achieving the potential benefits of partnering?



Dr Umesh Prabhu

Togetherness is always better. Just imagine if Scotland separates from United Kingdom! So unity is always the strength. Individually water is a drop but together it is a mighty ocean and very powerful. But sad reality in NHS there are many so called leaders with their own personal interest and keen to maintain their own position of power. NHS is a public organisation and paid by the public purse! The accountability is at local Trust Board level and NHS works in silos. NHS procurement is a good example. IT is one more example. NHS talks about togetherness but sad reality is NHS culture is one of 'Them and Us'. NHS wastes lot of money by not having single procurement. Each hospital orders costly CT, MRI and many other equipment and also waste lot of money on maintenance contract! Head-hunters take lot of commission for head-hunting staff from one NHS organisation to another! The amount of money wasted in these is simply shocking!

For NHS to work together, there must be clear governance arrangement. As long as have there is not clear accountability behaviour of Board or CEOs will not change and lot of money is wasted.

Culture of bullying is also rife and then there is club culture and all of these results in poor accountability for many senior leaders, managers and even consultants and nurses. This is not a criticism of any individuals but NHS system and process.

King's Fund has said clearly that we must have accountable care organisation. This can only happen when there is clear governance and accountability for organisations and the Boards.

There is absolutely no doubt 'Togetherness is key' but this will not happen as long as we have silos working and we do not have robust commissioning or service and clear accountability. Hopefully Devolution Manchester, STP and 5 Years plan will address governance and accountability structure as a matter of urgency and then we can save lots of money which we can re-use for Digital Transformation, Service Transformation and also start centralised procurement and invest that money for front line patient care.

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